The kidney conundrum: Evaluating the value of ifosfamide in cancer
therapeutics.
Abstract
Introduction: Ifosfamide is an alkylating chemotherapeutic
agent used in the treatment of various neoplasms. Its main adverse
effects include renal damage. Methods: A comprehensive review
was conducted, including 100 articles from the Scielo, Scopus, and
EMBASE databases. Results: Ifosfamide-induced nephrotoxicity is
attributed to its toxic metabolites, such as acrolein and
chloroacetaldehyde, which cause mitochondrial damage and oxidative
stress in renal tubular cells. An analysis of reported cases in the
literature showed an average age of 29 years, with no gender
predominance. In oncology patients treated with ifosfamide, a mortality
rate of 13% has been observed. Currently, no fully effective
therapeutic strategy exists for preventing ifosfamide-induced
nephrotoxicity; however, hydration, forced diuresis, and other
interventions are employed to limit renal damage. Long-term renal
function monitoring is essential for patients treated with ifosfamide.
Conclusions: Ifosfamide exhibits a broad spectrum of
antitumoral activity but may induce nephrotoxicity, adversely affecting
the prognosis of oncology patients. Therefore, a thorough evaluation of
the risks and benefits associated with its use is necessary.